Credentialing Specialist, Onboarding
About Eden Health
Eden Health is a nationally recognized medical practice on a mission to create a world where every person has a relationship with a trusted healthcare provider. Working with employers across the country, Eden Health offers employees 24/7 digital care, same-day in-person primary care, mental health services, physical therapy, and benefits navigation. The Eden Health team is driven by a patient-centric approach, delivering relationship-based collaborative care. With this model, our clients have healthier workforces, increased productivity, and reduced healthcare costs. We are committed to diversity, equity, and integrity, and our teams reflect this. Our hope at Eden Health is to create an environment where each person can do the best and most important work in their careers.
What you will be doing
As Eden Health’s Credentialing Specialist, Onboarding, you will be responsible for coordinating all facets of the provider onboarding process from offer acceptance through orientation by leading a compliant and positive onboarding experience for all new Eden providers. This role is a critical part of Eden Health’s Operations and is essential to our ability to onboard clinicians as well as our ability to expand our services to new geographical service areas.
As a Credentialing Specialist, Onboarding, you will report directly to the Licensing and Credentialing Manager. This is a full-time, remote-first role and has the flexibility to be located anywhere in the U.S.
What success looks like
- Invite new Eden Health providers to populate their demographic information in our credentialing/licensing software
- Ensure provider profiles are complete and updated in all systems including Eden’s credentialing/licensing software, CAQH, NPI, PECOS, etc.
- Credential and recredential new and existing Eden providers using NCQA, State, and Federal regulatory requirements
- Ensure proper supervision agreements are in place between advanced practice providers and physicians.
- Develop and maintain credentialing policies based on NCQA, State, and Federal regulatory requirements.
- Review provider information for accuracy and completeness.
- Perform Primary Source Verifications using NCQA, State, and Federal approved sources.
- Accurately prepare all required paperwork for provider credentialing files
- Maintain accurate and proper provider data in all systems
- Maintain professional working relationships with all internal and external stakeholders including physicians and health plans.
- Work closely with other areas of Eden Health to ensure coordination and timely credentialing/recredentialing
- Creating/updating providers’ CAQH ProView profile as well as NPPES, as needed
- Communicate potential issues with credentialing providers to key stakeholders.
- Provide assistance to licensing providers as needed
- Provide assistance to enrolling providers as needed
- Assists with special projects as needed.
What you will bring
- 2+ years of direct provider credentialing experience using NCQA, State and Federal regulatory requirements for MDs, DOs, NPs, PAs, PTs and Behavioral Health.
- 2+ years of Credentialing (PSV) experience
- Experience with licensing preferred
- Experience with payor enrollment preferred
- You are highly detail oriented
- You are a self-starter with the ability to work independently and proactively in a fast-paced, dynamic environment.
- You enjoy researching and digging into state compliance and regulatory requirements
- You have experience working with clinical providers
- You like to organize and improve processes and workflows
- Excellent verbal and written communication skills
Why Eden Health?
- Remote first company and culture
- Series C Healthtech startup with a mission-driven team that's passionate about helping every person have a relationship with a trusted healthcare provider
- Competitive salary and equity compensation package
- Medical, dental, and vision insurance and commuter benefits
- Dedicated Culture Committee led by CEO
- Learning and development budgets to help you grow and bond with your team
- Positive, inclusive, supportive culture cheering you on your journey
- Strong and quickly growing client base of America’s leading employers
Eden Health is an equal opportunity employer and encourages all applicants from every background and life experience without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
Please note: Eden Health interview requests and job offers only originate from edenhealth.com email addresses (e.g. [email protected]). Eden Health will never ask for bank information (e.g. account and routing number), social security numbers, passwords, or other sensitive information to be delivered via email. If you receive a scam email or wish to report a security issue involving Eden Health, please notify us at: security@edenhealth.com.